Abstract
Slipped capital femoral epiphysis (SCFE) in children after treatment of femoral neck fracture is a very rare condition. This complication should be recognized promptly and treated urgently. The risk of development of this complication can be minimized by anatomical reduction of the fracture and stable internal fixation of the fracture. Five years old male child sustained right sided femur neck fracture and was treated with closed reduction and Hip spica cast application. The fracture healed with a varus deformity. After 7 months, he developed slip of femoral epiphysis with a coxa vara deformity of proximal femur, which was treated with in situ fixation with Cannulated screws. His subsequent course remained uneventful up to five months. Slipped capital femoral epiphysis (SCFE) after treatment of femoral neck fracture in children is a rare complication that should be recognized and treated promptly. The onset of SCFE may show inadequate reduction or fixation of the fracture. Anatomic reduction and stable internal fixation for femoral neck fracture in children provides best outcomes. Postoperative care and delayed weight bearing are also equally important to avoid complications.
Highlights
Slipped capital femoral epiphysis (SCFE) in children after treatment of femoral neck fracture is a very rare condition that poses important treatment challenges[1] Femoral neck fractures in children are associated with high incidence of complications like avascular necrosis of femoral1
Slipped capital femoral epiphysis (SCFE) after treatment of femoral neck fracture can be caused by inadequate treatment of the fracture
There was no evidence of SCFE on plain radiographs taken at the time of the initial injury
Summary
Slipped capital femoral epiphysis (SCFE) in children after treatment of femoral neck fracture is a very rare condition that poses important treatment challenges[1] Femoral neck fractures in children are associated with high incidence of complications like avascular necrosis of femoral. The fracture was classified as per Delbet classification as type 3 He was treated with closed reduction under general anesthesia and Hip spica cast application (Fig.[1]). His serum vitamin D levels were 18ng/ml. The fracture healed with a varus deformity (neck shaft angle of 100 degrees) He was doing well up to seven months post surgery and was mobilized full weight bearing without support. Pak J Med Sci January 2020 Special Supplement ICON 2020 Vol 36 No 1 www.pjms.org.pk S94 His affected hip and started to limp. In situ fixation with Cannulated screws of the epiphyseal slip was performed His subsequent course remained uneventful up to five months (Fig.[3])
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